Nokea
A nonimmunized child appears at the clinic with a visible rash. Which of the following observations indicates the child may have rubeola (measles)?
- A. Small blue-white spots are visible on the oral mucosa.
- B. The rash begins on the trunk and spreads outward.
- C. There is low-grade fever.
- D. The lesions have a "teardrop-on-a-rose-petal"? appearance.
Correct Answer: A
Rationale: The presence of small blue-white spots on the oral mucosa, known as Koplik's spots, is characteristic of measles (rubeola) infection. These spots typically appear on the buccal mucosa opposite the second molars, 1-2 days before the rash onset, and last until 2 days after the rash appears. While Koplik's spots are pathognomonic for measles, their absence does not rule out the diagnosis. Therefore, choice A is the correct answer. Choices B, C, and D are incorrect because the rash pattern, presence of low-grade fever, and characteristic appearance of lesions are not specific indicators of measles infection.
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If you are caring for a patient of the Hindu culture, what may you anticipate regarding visitors?
- A. Limited visitors, respectful of privacy
- B. Family members only
- C. Large number of visitors/community support
- D. None of the above
Correct Answer: C
Rationale: In Hindu culture, there is a strong sense of community and support. It is common for a patient to receive a large number of visitors, indicative of the community coming together to provide emotional and practical support. This support network is crucial for the patient's well-being and healing process. Option A, limited visitors, is incorrect as the Hindu culture values community involvement. Option B, family members only, is incorrect as the support network extends beyond just family. Option D, none of the above, is incorrect as the Hindu culture typically involves community support and a significant number of visitors.
The key to the prevention of a pandemic influenza is:
- A. Early detection
- B. Early antibiotic treatment
- C. Vaccination of at-risk populations
- D. Isolation of suspected cases
Correct Answer: A
Rationale: The key to preventing a pandemic influenza is early detection. Detecting influenza cases early allows for timely public health responses to limit the spread of the virus. Early detection helps in implementing measures such as isolation, treatment, and vaccination to prevent the development of a full-blown pandemic. Antibiotics are not effective against influenza viruses, so early antibiotic treatment is not the key to prevention. While vaccination of at-risk populations is important in controlling the spread of influenza, early detection is crucial as it allows for timely implementation of vaccination strategies. Isolation of suspected cases is a containment measure rather than a prevention strategy; the key to prevention lies in early detection to stop the spread before it becomes a pandemic.
A child has recently been diagnosed with Duchenne muscular dystrophy (DMD). The parents are receiving genetic counseling prior to planning another pregnancy. Which of the following statements includes the most accurate information?
- A. Duchenne is an X-linked recessive disorder, so daughters have a 50% chance of being carriers and sons a 50% chance of developing the disease.
- B. Duchenne is an X-linked recessive disorder, so both daughters and sons have a 50% chance of developing the disease.
- C. Each child has a 1 in 4 (25%) chance of developing the disorder.
- D. Sons only have a 1 in 4 (25%) chance of developing the disorder.
Correct Answer: A
Rationale: The correct answer is that Duchenne is an X-linked recessive disorder, meaning the affected gene is located on one of the two X chromosomes of a female carrier. If a son receives the X chromosome bearing the gene, he will develop the disease, giving him a 50% chance of being affected. Daughters, on the other hand, are not affected by Duchenne but have a 50% chance of being carriers since they inherit one copy of the defective gene from the mother. The other X chromosome is inherited from the father, who cannot be a carrier. Therefore, choice A is accurate. Choice B is incorrect because daughters do not develop the disease, and sons have a 50% chance of developing, not both having a 50% chance. Choice C is incorrect as it does not consider the X-linked inheritance pattern of Duchenne. Choice D is inaccurate as it incorrectly states that only sons have a 25% chance of developing the disorder, omitting the carrier status of daughters.
A 23-year-old patient in the 27th week of pregnancy has been hospitalized on complete bed rest for 6 days. She experiences sudden shortness of breath, accompanied by chest pain. Which of the following conditions is the most likely cause of her symptoms?
- A. Myocardial infarction due to a history of atherosclerosis.
- B. Pulmonary embolism due to deep vein thrombosis (DVT).
- C. Anxiety attacks due to worries about her baby's health.
- D. Congestive heart failure due to fluid overload.
Correct Answer: B
Rationale: In a hospitalized patient on prolonged bed rest, the most likely cause of sudden onset shortness of breath and chest pain is pulmonary embolism. Pregnancy and prolonged inactivity both increase the risk of clot formation in the deep veins of the legs, known as deep vein thrombosis (DVT). These clots can dislodge and travel to the lungs, causing a pulmonary embolism. Myocardial infarction (Choice A) is less likely in a young patient without a significant history of atherosclerosis. Anxiety attacks (Choice C) may present with similar symptoms but are less likely in this context. Congestive heart failure (Choice D) is less probable given the acute onset of symptoms and absence of typical signs like peripheral edema in this case.
A patient in the cardiac unit is concerned about the risk factors associated with atherosclerosis. Which of the following are hereditary risk factors for developing atherosclerosis?
- A. Family history of heart disease
- B. Overweight
- C. Smoking
- D. Age
Correct Answer: A
Rationale: A family history of heart disease is an inherited risk factor for developing atherosclerosis. This factor is not modifiable through lifestyle changes. Studies have shown that having a first-degree relative with heart disease significantly increases the individual's risk of developing atherosclerosis. Overweight, smoking, and age are not hereditary risk factors for atherosclerosis. Overweight and smoking are lifestyle-related risk factors, while age is a non-modifiable risk factor that increases with time but is not directly inherited.